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Bailly M, Beraud D, Lambert C, Garnier YM, Pereira B, Duclos M, Boirie Y, Isacco L, Thivel D, Verney J. Constitutional thinness might be characterized by physiologically adapted and not impaired muscle function and architecture: new results from the NUTRILEAN study. Eur J Appl Physiol 2024:10.1007/s00421-024-05539-7. [PMID: 38900200 DOI: 10.1007/s00421-024-05539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE While muscle mass and skeletal muscle fibers phenotype have been shown atypical in constitutional thinness (CT), force production capacities and its architectural determinants have never been explored. The present study compared muscle functionality and architecture between participants with CT and their normal-weight (NW) counterparts. METHODS Anthropometry, body composition (Dual-X-ray Absorptiometry), physical activity/sedentary behavior (ActiGraph wGT3X-BT), ultrasound recording of the Vastus Lateralis (2D-ultrasound system), and functional capacities at maximal isometric and isokinetic voluntary contractions (MVCISO and MVCCON) during knee extension (isokinetic dynamometer chair Biodex) have been measured in 18 women with CT (body mass index < 17.5 kg/m2) and 17 NW women. RESULTS A lower fat-free mass (ES: -1.94, 95%CI: -2.76 to -1.11, p < 0.001), a higher sedentary time, and a trend for a lower time spent at low-intensity physical activity, were observed in CT vs NW participants. While absolute MVCISO, MVCCON, rate of torque development (RTD), and torque work were all markedly lower in CT, these differences disappeared when normalized to body or muscle mass. Muscle thickness and fascicle length were found lower in CT (ES: -1.29, 95%CI: -2.03 to -0.52, p < 0.001; and ES: -0.87, 95%CI: -1.58 to -0.15, p = 0.02, respectively), while pennation angle was found similar. CONCLUSION Despite lower absolute strength capacities observed in CT, present findings support the hypothesis of physiological adaptations to the low body and muscle mass than to some intrinsic contractile impairments. These results call for further studies exploring hypertrophy-targeted strategies in the management of CT.
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Affiliation(s)
- Mélina Bailly
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Duane Beraud
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Céline Lambert
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Yoann M Garnier
- Prognostic Factors and Regulatory Factors of Cardiac and Vascular Pathologies, EA3920, Université de Franche-Comté, 25000, Besançon, France
| | - Bruno Pereira
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, CHU Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Yves Boirie
- Department of Clinical Nutrition, CHU Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Laurie Isacco
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Julien Verney
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France.
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Boscaro A, Verney J, Tremblay A, King JA, Pereira B, Costes F, Julian V, Duclos M, Boirie Y, Thivel D, Bailly M. Challenges of considering both extremities of the weight status spectrum to better understand obesity: insights from the NUTRILEAN project in constitutionally thin individuals. Int J Obes (Lond) 2023; 47:1171-1177. [PMID: 37553452 DOI: 10.1038/s41366-023-01360-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/03/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND/OBJECTIVES While the physiology of obesity has been so extensively investigated to date, only an extremely small number of studies (less than 50) have focused on the other extremity of the weight spectrum: constitutional thinness. Yet, this important state of underweight in the absence of any eating disorders provides a mirror model of obesity that might be particularly insightful in understanding obesity. Nevertheless, important methodological and recruitment-related issues appear when it comes to this complex constitutionally thin phenotype, as experienced by our research group with the realization of the ongoing NUTRILEAN clinical trial. To face this challenge, the present paper aims at identifying, analyzing, and discussing the quality of such recruitment processes in publications about constitutional thinness. METHODS In this order, a group of experts collectively created a new grading system to assess the level of rigour and quality achieved by each study based on different criteria. RESULTS The main results were that (i) metabolic-related biasing criteria were poorly observed despite being crucial, (ii) recruitment processes were not detailed enough and with sufficient explicitness, and (iii) recruiting among already identified patients would be associated with both higher sample sizes and better scores of quality. CONCLUSIONS The present work encourages investigators to adopt a high level of rigour despite the complexity and duration of recruitment processes for this specific population, and readers to pay close attention to the quality of recruitment when interpreting the data. To better understand obesity and its physiological adaptations, it seems essential not only to compare it to normal-weight conditions, but also to the other extremity of the weight status spectrum represented by constitutional thinness.
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Affiliation(s)
- Audrey Boscaro
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UPR 3533, CRNH Auvergne, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Julien Verney
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UPR 3533, CRNH Auvergne, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - James A King
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Bruno Pereira
- Biostatistics Unit, Délégation à la Recherche Clinique et à l'Innovation (DRCI), Clermont-Ferrand, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Yves Boirie
- Department of Clinical Nutrition, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UPR 3533, CRNH Auvergne, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Mélina Bailly
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UPR 3533, CRNH Auvergne, University of Clermont Auvergne, Clermont-Ferrand, France
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Bailly M, Boscaro A, Thomas T, Féasson L, Costes F, Pereira B, Hager J, Estour B, Galusca B, Metz L, Courteix D, Thivel D, Verney J, Germain N. New Insights on Bone Tissue and Structural Muscle-Bone Unit in Constitutional Thinness. Front Physiol 2022; 13:921351. [PMID: 35874537 PMCID: PMC9305386 DOI: 10.3389/fphys.2022.921351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
While few studies pointed out low bone mineral densities in constitutionally thin women, little is known about potential explanations. The objective was to further explore bone architecture in both women and men with constitutional thinness to investigate their mechanical muscle-bone coupling (or uncoupling). Thirty constitutionally thin people and 31 normal weight controls participated in the study. Body composition, hip structural analysis, and trabecular bone score were assessed by dual-energy X-ray absorptiometry, bone architecture using high-resolution peripheral quantitative computed tomography, and muscle explorations through histological staining on muscle biopsies. Thirty-two out of the 48 indexes relative to density, geometry, texture, and architecture of bones were found significantly lower (p < 0.05) in constitutionally thin individuals compared with controls. This observation was particularly pronounced in constitutionally thin men. Bone microarchitecture was more altered in weight-supporting bone (tibia) than in non-weight-supporting (radius) bone, which might refer to a normal physiological adaptation (Frost’s mechanostat theory). Yet, the heat-maps of correlations analyses showed many alterations of body weight or muscle associations with bone parameters in constitutionally thin individuals contrary to controls. Present results might support the idea of intrinsic disturbances of bone cells independently to the small muscle structure, particularly in men.
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Affiliation(s)
- Mélina Bailly
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
- *Correspondence: Mélina Bailly,
| | - Audrey Boscaro
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - Thierry Thomas
- Department of Rheumatology, Hôpital Nord, CHU, Saint-Étienne, France
- INSERM U1059, University of Lyon-Jean Monnet University, Saint-Étienne, France
| | - Léonard Féasson
- Inter-University Laboratory of Human Movement Biology (LIBM) EA 7424, Jean Monnet University, Saint-Étienne, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, CHU, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit, Délégation à la Recherche Clinique et à l’Innovation (DRCI), Clermont-Ferrand, France
| | - Jorg Hager
- Metabolic Health Nestlé Research, Lausanne, Switzerland
| | - Bruno Estour
- Eating Disorders Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes Metabolism and Eating Disorders, CHU, Saint-Étienne, France
| | - Bogdan Galusca
- Eating Disorders Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes Metabolism and Eating Disorders, CHU, Saint-Étienne, France
| | - Lore Metz
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - Daniel Courteix
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - David Thivel
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - Julien Verney
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - Natacha Germain
- Eating Disorders Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes Metabolism and Eating Disorders, CHU, Saint-Étienne, France
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Bailly M, Boscaro A, Pereira B, Féasson L, Boirie Y, Germain N, Galusca B, Courteix D, Thivel D, Verney J. Is constitutional thinness really different from anorexia nervosa? A systematic review and meta-analysis. Rev Endocr Metab Disord 2021; 22:913-971. [PMID: 33929658 DOI: 10.1007/s11154-021-09650-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 01/03/2023]
Abstract
A growing interest in constitutional thinness has been observed in the last decades, but the publications however cover various fields of study and report equivocal results. The present work systematically reviewed any clinical trials enrolling participants with constitutional thinness and bibliographic researches were performed between December 2018 and June 2020. From a total of 1 212 records initially identified, 402 records were removed as duplicates, 381 articles were excluded based on titles or abstracts and 390 references were excluded against eligibility criteria. Thirty-nine articles were finally included in the systematic review. The results showed that constitutionally thin people seem to be underweight but not underfat and present a fat-free mass as blunted as anorexic patients, despite being a little less underweight. The meta-analysis confirmed that constitutionally thin people present normal energy intake and revealed a trend toward a higher resting metabolic rate to fat-free mass ratio which suggests a highly metabolic fat-free mass. Contrary to patients with anorexia nervosa, constitutionally thin people present normal levels of insulin-like growth factor 1, estradiol, growth hormone, follicle-stimulating hormone, and luteinizing hormone. An intermediate level of leptin between anorexic and control participants was however observed in constitutional thinness. While all the studies reported normal free triiodothyronine and cortisol levels in constitutionally thin individuals, a higher fasting free triiodothyronine level (p = 0.033) and a lower 24 h mean cortisol level (p = 0.005) were observed for the first time. Present results give robust evidence that constitutionally thin people present an atypical phenotype highly different from anorexia nervosa.
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Affiliation(s)
- Mélina Bailly
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
| | - Audrey Boscaro
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France.
| | - Bruno Pereira
- Biostatistics Unit, Délégation À La Recherche Clinique Et À L'Innovation (DRCI), Clermont-Ferrand, France
| | - Léonard Féasson
- Inter-University Laboratory of Human Movement Biology (LIBM) EA 7424, Université Jean Monnet, Saint-Étienne, France
| | - Yves Boirie
- Department of Human Nutrition, G. Montpied Hospital, CHU Clermont-Ferrand, Clermont-Ferrand, France
- INRAE, UMR 1019, Clermont-Ferrand, France
| | - Natacha Germain
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes, Metabolism and Eating Disorders, CHU, Saint-Étienne, France
| | - Bogdan Galusca
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes, Metabolism and Eating Disorders, CHU, Saint-Étienne, France
| | - Daniel Courteix
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France
| | - David Thivel
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France.
| | - Julien Verney
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France
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Underweight but not underfat: is fat-free mass a key factor in constitutionally thin women? Eur J Clin Nutr 2021; 75:1764-1770. [PMID: 33772214 DOI: 10.1038/s41430-021-00895-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/05/2021] [Accepted: 02/23/2021] [Indexed: 02/01/2023]
Abstract
Constitutional thinness is defined as a state of severe underweight with a body mass index similar to anorectic patients (BMI < 17.5 kg/m2), in the absence of any eating disorders or other obvious disruptive factors impacting energy balance. The analysis of body composition is essential as a first approach to characterize constitutional thinness and might help identify new discriminating differences between constitutional thinness and anorexia nervosa. A meta-analytical approach was performed to compare body composition of constitutionally thin, anorectic, and normal-weight subjects from all available studies found in the literature. The statistical analysis was carried out on large sample sizes: n = 205 females with constitutional thinness, n = 228 normal-weight control females, and n = 258 females with anorexia nervosa. Despite being as underweight as anorectic patients, constitutionally thin participants paradoxically presented higher percentages of fat mass than anorectic patients (18.9% vs. 11.4%, respectively; SMD [95% CI]: 1.62 [1.16; 2.08]), even found in the normal healthy ranges. Constitutionally thin people, however, display as low fat-free mass as anorectic patients. These observations question the use of high-fat diets in this population and bring new insights for nutrition and/or training strategies directed toward muscle mass gain. The present results give new elements to further distinguish constitutional thinness from anorexia nervosa and reinforce the need to better investigate the atypical phenotype of constitutional thinness.
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Bailly M, Germain N, Féasson L, Costes F, Estour B, Hourdé C, N Merlet A, Thomas T, Hager J, Pereira B, Thivel D, Courteix D, Galusca B, Verney J. Skeletal muscle of females and males with constitutional thinness: a low intramuscular lipid content and oxidative profile. Appl Physiol Nutr Metab 2020; 45:1287-1298. [PMID: 32479741 DOI: 10.1139/apnm-2020-0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Constitutional thinness (CT) is a nonpathological state of underweight. The current study aimed to explore skeletal muscle energy storage in individuals with CT and to further characterize muscle phenotype at baseline and in response to overfeeding. Thirty subjects with CT (15 females, 15 males) and 31 normal-weight control subjects (16 females, 15 males) participated in the study. Histological and enzymological analyses were performed on muscle biopsy specimens before and after overfeeding. In the skeletal muscle of CT participants compared with controls, we observed a lower content of intramuscular triglycerides for type I (-17%, p < 0.01) and type IIA (-14%, p < 0.05) muscle fibers, a lower glycogen content for type I (-6%, p < 0.01) and type IIA (-5%, p < 0.05) muscle fibers, a specific fiber-type distribution, a marked muscle hypotrophy (-20%, p < 0.001), a low capillary-to-fiber ratio (-19%, p < 0.001), and low citrate synthase activity (-18%, p < 0.05). In response to overfeeding, CT participants increased their intramuscular triglycerides content in type I (+10%, p < 0.01) and type IIA (+9%, p < 0.01) muscle fibers. CT individuals seem to present an unusual muscle phenotype and different adaptations to overfeeding compared with normal-weight individuals, suggesting a specific energy metabolism and muscle adaptations. ClinicalTrials.gov registration no. NCT02004821. Novelty Low intramuscular triglycerides and glycogen content in skeletal muscle of constitutionally thin individuals. Low oxidative capacity, low capillary supply, and fiber hypotrophy in skeletal muscle of constitutionally thin individuals. Increase in intramuscular triglycerides in constitutional thinness in response to overfeeding.
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Affiliation(s)
- Mélina Bailly
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand 63000, France.,Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne 42000, France
| | - Natacha Germain
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne 42000, France.,Division of Endocrinology, Diabetes, Metabolism and Eating Disorders, CHU Saint-Étienne 42000, France
| | - Léonard Féasson
- Inter-University Laboratory of Human Movement Biology (LIBM) EA 7424, Jean Monnet University, Saint-Étienne 42000, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, CHU Clermont-Ferrand 63000 France
| | - Bruno Estour
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne 42000, France.,Division of Endocrinology, Diabetes, Metabolism and Eating Disorders, CHU Saint-Étienne 42000, France
| | - Christophe Hourdé
- Inter-University Laboratory of Human Movement Biology (LIBM) EA 7424, Savoie Mont Blanc University, Chambéry 73000, France
| | - Angèle N Merlet
- Inter-University Laboratory of Human Movement Biology (LIBM) EA 7424, Jean Monnet University, Saint-Étienne 42000, France
| | - Thierry Thomas
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, France.,INSERM U1059, University of Lyon-Jean Monnet University, Saint-Étienne 42000, France
| | - Jorg Hager
- Metabolic Health, Nestlé Research, EPFL Innovation Park, Lausanne 1015, Switzerland
| | - Bruno Pereira
- Biostatistics Unit, Délégation à la Recherche Clinique et à l'Innovation (DRCI), Clermont-Ferrand 63000, France
| | - David Thivel
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand 63000, France
| | - Daniel Courteix
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand 63000, France
| | - Bogdan Galusca
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne 42000, France.,Division of Endocrinology, Diabetes, Metabolism and Eating Disorders, CHU Saint-Étienne 42000, France
| | - Julien Verney
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand 63000, France
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Abstract
The existing literature about the definition and diagnostic criteria of constitutional thinness (CT) appears equivocal. The present work systematically reviewed the criteria used in the diagnosis of adult individuals with CT (PROSPERO registration number: CRD42019138236). Five electronic bibliographic databases were searched between December 2018 and November 2019: MEDLINE, Embase, CENTRAL (Cochrane Library), Google Scholar and Clinical Trials. Search terms were combined with Medical Subject Headings terms. The search strategy included any clinical trials that enrolled adults with CT. Studies were systematically excluded if the state of thinness was not due to a well-identified constitutional origin. From the 689 references after duplicate removal, 199 studies were excluded based on title and 164 based on abstract. According to the inclusion and exclusion criteria, 291 other studies were removed. Finally, thirty-five studies remained at the end of the process. The analysis of these studies showed high heterogeneity in the diagnostic criteria of CT. A real need emerged to adopt a common terminology and to systematically exclude potential non-constitutional origins of thinness such as eating disorders, associated pathology or over-exercising, with validated tools. Weight history, physiological menses and weight gain resistance are also important criteria to consider. The present systematic review revealed that our medical and scientific approaches of CT need to be harmonised in terms of terminology and diagnostic criteria. Although further studies are needed, we finally proposed recommendations and a decision tree to help in the recognition and diagnosis of CT.
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Kanatani KT, Nakayama T, Adachi Y, Hamazaki K, Onishi K, Konishi Y, Kawanishi Y, Go T, Sato K, Kurozawa Y, Inadera H, Konishi I, Sasaki S, Oyama H. High frequency of vitamin D deficiency in current pregnant Japanese women associated with UV avoidance and hypo-vitamin D diet. PLoS One 2019; 14:e0213264. [PMID: 30830935 PMCID: PMC6398852 DOI: 10.1371/journal.pone.0213264] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 02/18/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As a consequence of indoor occupations and reduced exposure to sunlight, concerns have been raised that vitamin D deficiency is widespread in developed countries. Vitamin D is known to be associated with increased risks of morbidity and mortality in various diseases. OBJECTIVE To investigate the serum vitamin D status and its relation with life-style factors in pregnant Japanese women. METHODS Among a cohort for 3,327 pregnant women who participated in an the adjunct study of the Japan Environment and Children's Study during 2011-2013, in which data were obtained on various life-style factors, including both dietary intake of vitamin D and frequency of UV exposure, this study consisted of 1,592 pregnant women, from whom 2,030 serum samples were drawn in Jan, Apr, Jul, and Oct, and the association between serum 25(OH)D level and life-style factors were analyzed using linear mixed models. RESULTS Serum 25(OH)D levels were less than 20ng/mL in 1,486 of 2,030 samples (73.2%). There was an obvious seasonal change, with serum 25(OH)D levels of less than 20 ng/mL in 89.8% and 47.8% of samples in spring (April) and autumn (October), respectively. Both the frequency spent under sunlight and dietary intake of vitamin D were significantly associated with serum 25(OH)D level. An increase in sunlight exposure of more than 15 min for 1 to 2 days per week in non-winter, or dietary intake of 2 μg/day of vitamin D resulted in an elevation of 1 ng/mL in serum 25(OH)D levels. CONCLUSION These findings indicate that vitamin D deficiency is very severe in Japanese pregnant women, especially those rarely exposed to sunlight. The benefits of UV rays should also be informed of when its risk is alerted, and clinicians should propose the adequate UV exposure level.
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Affiliation(s)
- Kumiko T. Kanatani
- Kyoto Regional Centre for Japan Environment and Children’s Study, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
- * E-mail:
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yuichi Adachi
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kei Hamazaki
- Department of Public Health, University of Toyama, Toyama, Japan
| | - Kazunari Onishi
- Department of Public Health, Tottori University, Tottori, Japan
| | - Yukuo Konishi
- Doshisha University Center for Baby Science, Kyoto, Japan
| | | | - Tohshin Go
- Kyoto Regional Centre for Japan Environment and Children’s Study, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keiko Sato
- Kyoto Regional Centre for Japan Environment and Children’s Study, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan
| | | | - Hidekuni Inadera
- Department of Public Health, University of Toyama, Toyama, Japan
| | - Ikuo Konishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Tokyo, Japan
| | - Hiroshi Oyama
- Department of Clinical Information Engineering Health Services Sciences, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Kong B, Bruns P, Raulefs S, Rieder S, Paul L, Prazeresda Costa O, Buch T, Theis FJ, Michalski CW, Kleeff J. Metabolism gene signatures and surgical site infections in abdominal surgery. Int J Surg 2015; 14:67-74. [PMID: 25599917 DOI: 10.1016/j.ijsu.2015.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/14/2014] [Accepted: 01/13/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Surgical site infections (SSI) represent a significant cause of morbidity in abdominal surgery. The objective of this study was to determine the gene expression signature in subcutaneous tissues in relation to SSI. METHODS To determine differences in gene expression, microarray analysis were performed from bulk tissue mRNA of subcutaneous tissues prospectively collected in 92 patients during open abdominal surgery. 10 patients (11%) developed incisional (superficial and deep) SSI. RESULTS Preoperative risk factors in patients with SSI were not significantly different from those in patients without wound infections. 1025 genes were differentially expressed between the groups, of which the AZGP1 and ALDH1A3 genes were the highest down- and upregulated ones. Hierarchical clustering demonstrated strong similarity within the respective groups (SSI vs. no-SSI) indicating inter-group distinctness. In a functional classification, genes controlling cell metabolism were mostly down-regulated in subcutaneous tissues of patients that subsequently developed SSI. CONCLUSION Altered expression of metabolism genes in subcutaneous tissues might constitute a risk factor for postoperative abdominal SSI.
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Affiliation(s)
- Bo Kong
- Department of Surgery, Technische Universität München, Munich, Germany
| | - Philipp Bruns
- Department of Surgery, Technische Universität München, Munich, Germany; Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Munich, Germany
| | - Susanne Raulefs
- Department of Surgery, Technische Universität München, Munich, Germany
| | - Simon Rieder
- Department of Surgery, Technische Universität München, Munich, Germany
| | - Laura Paul
- Department of Surgery, Technische Universität München, Munich, Germany
| | | | - Thorsten Buch
- Institute of Microbiology, Technische Universität München, Munich, Germany
| | - Fabian J Theis
- Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Munich, Germany
| | | | - Jörg Kleeff
- Department of Surgery, Technische Universität München, Munich, Germany.
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Landal AC, Monteiro F, Hevely BCDS, Kanesawa LM, Hernandes N, Pitta F. Fatores associados à melhora da composição corporal em indivíduos com DPOC após treinamento físico. FISIOTERAPIA EM MOVIMENTO 2014. [DOI: 10.1590/0103-5150.027.004.ao15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introdução A redução da massa magra corpórea (MMC) é um fator independente de mortalidade em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC) e a literatura mostra que exercícios físicos aumentam a MMC. Objetivo Identificar fatores associados à melhora da composição corporal em indivíduos com DPOC após treinamento físico de alta intensidade. Métodos 37 pacientes com DPOC (19 H; 66 ± 7 anos; IMC = 27 ± 6 kg/m2; VEF1 = 38 ± 16 %pred) foram avaliados segundo sua composição corporal, função pulmonar, força muscular respiratória e periférica, capacidade funcional de exercício (teste de caminhada dos seis minutos, TC6M), nível de atividade física diária (DynaPort®), sensação subjetiva de dispneia (escala Medical Research Council) e qualidade de vida (Saint George Respiratory Questionnaire). O treinamento conteve exercícios de endurance e força muscular (3 vezes por semana por três meses). Após três meses, os pacientes foram reavaliados. Aqueles que apresentaram incremento de MMC incorporaram à estatística. Resultados No pré-treinamento, a MMC se correlacionou significativamente (p ≤ 0,05) com gasto energético total (r = 0,57), TC6M em %predito (r = 0,46), pressão expiratória máxima (PEmax) (r = 0,57), volume expiratório forçado no primeiro segundo em %predito (r = 0,47), força muscular de quadríceps femoral (r = 0,54), bíceps (r = 0,62) e tríceps braquial (r = 0,63). Contudo, o incremento da MMC após treinamento correlacionou-se significativamente somente com a melhora das escalas MRC (r = 0,4; p = 0,05) e PEmax (r = 0,35; p = 0,04). Conclusão Apesar de a MMC de pacientes com DPOC estar relacionada com a capacidade funcional de exercício, força muscular respiratória e periférica, obstrução pulmonar e gasto energético no pré-tratamento, a melhora da composição corporal está relacionada somente ao incremento da força muscular expiratória e sensação de dispneia após treinamento físico de alta intensidade.
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